大黄对重型颅脑损伤后应激性溃疡的预防作用  

Prophylactic effect of rhubarb on severe brain injury induced stress ulcer in rats

作　　者：郭世文[1] 蔡珂[1] 车红民[1] 廉民学[1] 姜海涛[1] 

机构地区：[1]西安交通大学医学院第一附属医院神经外科,西安710061

出　　处：《中华神经医学杂志》2011年第1期50-54,共5页Chinese Journal of Neuromedicine

摘　　要：目的 探讨重型颅脑损伤后应激性溃疡的发生机制及大黄对重型颅脑损伤后应激性溃疡的预防作用.方法 成年雄性SD大鼠40只按随机数字表法分为假手术组、模型组、大黄治疗组和奥美拉唑治疗组,每组10只.后3组大鼠采用改良的Feeney自由落体法制备重型颅脑损伤模型,大黄治疗组和奥美拉唑治疗组大鼠在模型后分别给予大黄粉悬浊液灌胃和奥美拉唑口服.模型后2、6、24 h对各组大鼠行神经损害严重程度评分（NSS）;于模型后24 h采用激光血流仪探头检测各组大鼠胃黏膜血流（pu）,取胃前壁组织观察并测量黏液层厚度（μm）;HE染色观察胃黏膜的病理变化并计算溃疡指数（UI）.结果 与假手术组比较,模型组、大黄治疗组和奥美拉唑治疗组大鼠NSS评分较低,差异有统计学意义（P＜0.05）;与模型组比较,大黄治疗组和奥美拉唑治疗组大鼠模型后24 h胃黏膜血流和黏液层厚度增加,溃疡指数降低,且大黄治疗组大鼠胃黏膜血流和黏液层厚度均高于奥美拉唑治疗组,差异有统计学意义（P＜0.05）;大鼠NSS评分、胃黏膜血流、黏液层厚度与溃疡指数之间均呈现明显的负相关关系（r=-0.429,P=0.002;r=-0.542,P=0.013;r=-0.465,P=0.024）.而胃黏膜血流和胃黏膜黏液层厚度之间呈正相关关系（r=0.680,P=0.001）.结论 大黄对颅脑损伤后应激性溃疡有预防性作用,且不减少黏液的分泌,但对颅脑损伤大鼠短期内的行为学评分无明显改善.Objective To explore the mechanism of stress ulcer induced by severe brain injury and prophylactic effect of rhubarb on this stress ulcer in rats. Methods Forty adult male SD rats were equally randomized into sham-operated group, model group, rhubarb treatment group and omeprazole treatment group （n=10）. Rat models of craniocerebral injury in the later 3 groups were established according to modifiod Feeney＇s method; and then, rhubarb in a suspension manner was given by way of ig into the rhubarb treatment group and omeprazole was given orally to rats in the omeprazole treatment group. The neurological severity scale （NSS） was performed 2, 6 and 24 h after the brain injury. The gastric mucosal blood flow （GMBF） was measured by probe test with laser Joppler flowmetry; thickness of the slime layer was measured; pathological changes of mucous mermbrane were observed by HE staining and the ulcer index was calculated 24 h after the brain injury. Results As compared with the sham-operated group, the other 3 groups enjoyed significantly lower scores of NSS （P〈0.05）. Thickness of the slime layer and GMBF in the rhubarb and omeprazole treatment groups were obviously increased,and ulcer index in them was obviously decreased as compared with those in the model group （P〈0.05）;the levels of thickness of the slime layer and GMBF in the rhubarb treatment group were significantly higher than those in the omeprazole treatment group （P〈0.05）. The scores of NSS, thickness of the slime layer and GMBF were negatively correlated to the ulcer index（r=-0.429, P=0.002; r=-0.542, P=0.013;r=-0.465, P=0.024）. Positive correlation was noted between thickness of the slime layer and GMBF（r=0.680, P=0.001）. Conclusion Prophylactic effect ofrhubarb on severe brain injury induced stress ulcer is noted in rats. But the rhubarb may neither reduce the mucus secretion nor improve the scores of behavioral evaluation in a short term.

关 键 词：颅脑损伤 胃溃疡 大黄素 

分 类 号：R285.5[医药卫生—中药学]